Clin Hypertens.  2018 ;24(1):12. 10.1186/s40885-018-0095-3.

Albumin-to-creatinine ratio as a predictor of all-cause mortality and hospitalization of congestive heart failure in Chinese elder hypertensive patients with high cardiovascular risks

• Liu M
• Liang Y
• Zhu J
• Yang Y
• Ma W
• Zhang G

• KMID: 2434266
• DOI: http://doi.org/10.1186/s40885-018-0095-3

Abstract

BACKGROUND
Data are limited with regard to the relationship of albuminuria and major adverse cardiovascular events (MACE) in Chinese elder patients with high cardiovascular risk.
METHODS
We did a retrospective cohort study using Chinese elder patients with high cardiovascular risks (n"‰="‰1474) to identify the association of albumin-to-creatinine ratio (ACR) and the incidence of MACE and all-cause mortality. Individuals were followed up from January, 2002 to November, 2007. The all-cause mortality and MACE, composite outcome of cardiovascular death, myocardial infarction, stroke and hospitalization of congestive heart failure were defined as primary endpoint.
RESULTS
During the median following up of 56 months, 213 patients developed primary endpoint and 117 patients died. Patients with higher baseline urinary ACR (>"‰30 mg/g) experienced a nearly 2-fold of all-cause mortality and a 3-fold of heart failure hospitalization than those with lower baseline urinary ACR (≤10 mg/g).MACE, cardiovascular death, stoke and myocardial infarction showed no difference in three grades of urinary ACR (>"‰30 mg/g, 10 mg/g-30 mg/g, ≤10 mg/g) in this cohort. Patients above 65 years with increased ACR tended to experience higher mortality risks, and the association of increased ACR with higher hospitalization of congestive heart failure seemed to be more prominent in patients below 65 years than above 65 years.
CONCLUSIONS
In this post hoc analysis of Chinese individuals with high cardiovascular risks, higher urinary ACR was associated with higher all-cause mortality and heart failure hospitalization. Further studies are needed to find out whether there is age-specific ACR cutoff point. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40885-018-0095-3) contains supplementary material, which is available to authorized users.

Keyword

Albumin-to-creatinine ratio; Cardiovascular disease; Aging; Mortality; Heart failure hospitalization

MeSH Terms

Aging
Albuminuria
Asian Continental Ancestry Group*
Cardiovascular Diseases
Cohort Studies
Estrogens, Conjugated (USP)*
Heart Failure*
Hospitalization*
Humans
Incidence
Mortality*
Myocardial Infarction
Retrospective Studies
Stroke
Estrogens, Conjugated (USP)